Provider Demographics
NPI:1730962044
Name:AMPLECARE LLC
Entity type:Organization
Organization Name:AMPLECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEEPA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAJAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-668-6164
Mailing Address - Street 1:2561 GOODRICH RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1094
Mailing Address - Country:US
Mailing Address - Phone:949-395-0070
Mailing Address - Fax:
Practice Address - Street 1:2561 GOODRICH RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-1094
Practice Address - Country:US
Practice Address - Phone:949-395-0070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health